Objective To investigate the effects of different modes of intermittent pneumatic compression（IPC） in preventing deep vein thrombosis（DVT） in patients undergoing laparoscopic rectal cancer surgery.Methods From April 2020 to April 2021,130 patients for laparoscopic radical rectal cancer surgery（Dixon） were sequentially selected in a tertiary hospital,and they were divided into the control group,group Ⅰ,group Ⅱ,and groupⅢ by random number table method. The control group were routinely treated to prevent thrombosis during perioperative period,and other groups were treated with corresponding IPC mode during the operation on the basis of the treatment in the control group. Specifically,group Ⅰ adopted the IPC bipedal mode,and the plantar airbag was applied to 130 mmHg for 6 s,and then relaxed for 12 s. Group Ⅱ adopted the IPC double calf model,and the airbag was applied to the calf sequentially by 80 mmHg for 12 s and relaxed for 24 s. Group Ⅲ adopted IPC double calf + thigh mode,and airbags sequentially pressed 80 mmHg,70 mmHg and 60 mmHg from the ankle,calf and thigh respectively for 24 s and relaxed for 24 s. The venous hemodynamic changes of the lower extremities and the incidence of DVT in the 4 groups were compared before and after operation.Results Compared with the control group,group Ⅰ and group Ⅱ have statistically significant differences in the velocity rates of bilateral femoral common,superficial and popliteal veins before and after surgery（P<0.05）,while there is no difference in the change of blood vessel caliber. The incidences of DVT on the first day were improved significantly（P=0.039,P=0.042）,respectively. Compared with those in the control group,there were no significant difference in the velocity rates of bilateral total femoral veins,as well as the change of blood vessel caliber of bilateral common femoral vein,superficial femoral vein and popliteal vein in the group Ⅲ（P>0.05）. The incidence of DVT on the first day after surgery was not improved（P=0.820）. There were no statistically significant differences in the incidences of DVT between the 4 groups on the 7th day after surgery（P=0.125）.Conclusion Both the IPC foot mode and the IPC leg mode can reduce the incidence of DVT on the first day after laparoscopic rectal cancer surgery with similar efficacy.

Objective An intervention strategy was developed based on an intervention map to investigate its effect on medication adherence in patients with acute coronary syndrome combined with moderate to severe chronic kidney disease. Methods A convenience sampling method was used to select 101 patients with acute coronary syndrome combined with moderate-to-severe chronic kidney disease admitted to the cardiology department of a tertiary hospital in Wenzhou from September 2020 to April 2021,and they were selected as study subjects and randomly divided into a test group and a control group. The test group used the medication intervention strategy developed by the intervention mapping,and the control group used the conventional medication strategy. The medication adherence,quality of life and rehospitalization due to cardiovascular events were compared between the 2 groups. Results A total of 97 patients completed the study with 48 in the test group and 49 in the control group. There were no significant differences in medication adherence scores and 36 concise health status survey scales scores between the two groups at discharge and 1 month after discharge（P>0.05）,and the scores were higher in the test group at both 3 months and 6 months after discharge（P<0.05）. The readmission rates for cardiovascular events 6 months after discharge between the 2 groups were compared,and the difference was statistically significant （P<0.05）,and the Cox proportional risk model showed that the risk of rehospitalization was relatively lower in the test group（HR=0.430,95%CI=0.187~0.990）. Conclusion Medication intervention strategies developed by inter-vention mapping can improve medication adherence,quality of life and clinical prognosis in patients with acute coronary syndrome combined with moderate-to-severe chronic kidney disease.

Objective To systematically evaluate nurses’ nursing experience in maintaining patient dignity and provide the evidence for promoting clinical nursing care. Methods The following databases including Cochrane Library,Joanna Briggs Institute EBP Database,PubMed,Embase,PsycINFO,CINAHL,Web of Science,CNKI,Wanfang Data,VIP,CBMdisc were searched from inception to July 2020 to collect qualitative studies in the nurses’ perspectives of maintaining patient dignity. After evaluating the quality of studies according to the JBI Critical Appraisal Tool for qualitative studies（2016 edition）,the meta-synthesis was applied to integrate the results. Results A total of 7 pieces of research were included with 26 specific research results,and then 9 categories and 3 integrated results were extracted,which were the practice of maintaining patient dignity from various aspects,nurses’ personal and external environmental factors affecting the practice of maintaining patient dignity. Conclusion The dignity campaign needs to be promoted by nurses,nursing managers,hospitals and the society. Nursing managers should attach importance to the education of dignity,nurse training and reformation of related systems,to promote the practice of maintaining patient dignity.

Objective To investigate the current status of frailty in elderly hospitalized patients with non-valvular atrial fibrillation（NVAF） and to analyze the influencing factors. Methods The convenience sampling method was used to select 183 elderly patients aged 60 years and older who were diagnosed with NVAF and hospitalized in the Department of Cardiovascular Medicine of a tertiary hospital in Wenzhou from March 2020 to October 2020.The general patient data,laboratory parameters,cardiac ultrasound parameters,and health data were collected by the General Information Questionnaire,Frail Frailty Questionnaire,Barthel Index,Activity of Daily Living Scale（ADL）and Padua score for risks of deep vein thrombosis in medical inpatients. Statistical methods including single factor and multifactor analysis were conducted for influencing factors of frailty in the elderly patients with atrial fibrillation. Results The pre-frailty and frailty rates in 183 elderly patients with NVAF were 39.9% and 28.4%,respectively,and only 31.7% were non-frailty. The results of ordered multiple Logistic regression showed that age,sex,cardiac ejection fraction,left atrial internal diameter,and ADL were influential factors in the frailty of elderly patients with NVAF（P<0.05）. Conclusion Elderly patients with NVAF have a high incidence of frailty and a large proportion of patients are in the pre-frailty. Age,sex,cardiac ejection fraction,left atrial internal diameter,ADL and the deep vein thrombosis risk are influential factors in frailty. Frailty screening and management should be carried out as early as possible during hospitalization for elderly patients with NVAF to improve their ADL and quality of life.

Objective To understand the psychological experience of juvenile patients committing poisoning suicide,so as to provide references for clinical nurses to carry out relevant preventive interventions. Methods The phenomenological method was used,and 11 adolescents committing poisoning suicides admitted to Wenzhou hospital from June to December 2019 were interviewed by semi-structured interviews,and the data was analyzed by Colaizzi seven-step method. Results 4 themes were extracted,including the lack of effective communication,unbearable situation,uncontrolled emotion and contradictory self-view. Conclusion Juvenile poisoning suicide patients have many needs and problems in psychological care,psychological growth and self-emotional regulation. Nurses should provide these juveniles based on their psychological experience,in order to promote their physical and mental health.

Objective To explore the application value of skin temperature in early warning of pressure injury through analyzing the correlation between skin temperature and pressure injury and quantifying the risk level by temperature indicator. Methods A total of 415 inpatients from comprehensive ICU,neurosurgical ICU,respiratory ICU,emergency department ICU and CCU in a tertiary hospital in Wenzhou were selected by continuous cluster sampling. Demographic and clinical data were obtained,as well as daily skin temperature of sacral area. The correlation between skin temperature and pressure injury was analyzed by Spearman rank correlation. The X-tile analysis was used to acquire the optimal cutoff value of skin temperature,and the prediction effect was evaluated by the receiver operating characteristic curve. The occurrence risk of pressure injury with different skin temperature was compared by Kaplan-Meier survival curve analysis and COX proportional hazard regression model. Results There was a negative correlation between the relative skin temperature of sacral area and the occurrence of pressure injury（P<0.001）. The optimal cutoff value of this indicator for predicting pressure injury was -0.1 ℃. The area under the receiver operating characteristic curve of this indicator was 0.901,with the Youden index of 0.753,the sensitivity of 85.37%,the specificity of 89.89%. When the relative temperature in sacral area was below -0.1 ℃,the incidence of pressure injury increased significantly,with the highest incidence rate on the 4th and 5th day after admission（3.44%）. The risk was 6.63 times higher than that of the temperature above -0.1 ℃[HR=6.36,95%CI（3.91~10.36）]. Conclusion Skin temperature monitoring can effectively predict the occurrence of pressure injury. It is recommended to pay close attention to changes of the skin temperature at sacral area on the 4th and 5th day after admission. The decreased skin temperature（the relative temperature≤-0.1℃） means the higher risk of pressure injury,and precautions should be taken timely to reduce the incidence of pressure injury.